Despite Ezekiel Emanuel’s recommendations in his lead article “Why I Hope to Die at 75” in the current Atlantic magazine, I will join Jews around the world this Rosh Hashanah and Yom Kippur in praying to continue to be inscribed in the heavenly book of life.
Emanuel does seem to have great credentials. He is Director of the Clinical Bioethics Department at the U.S. National Institutes of Health and heads the Department of Medical Ethics & Health Policy at the University of Pennsylvania. With a resume like that you might be tempted to take his views seriously. After all he offers some interesting reasons why he believes there’s no point in living beyond the age 75 when, as he puts it, “he will have lived a complete life – and it’s all downhill from there.”
Here’s how he explains why he will make no effort for longevity after his self-selected age for decrepitude:
But here is a simple truth that many of us seem to resist: living too long is also a loss. It renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived. It robs us of our creativity and ability to contribute to work, society, the world. It transforms how people experience us, relate to us, and, most important, remember us. We are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic.
In short, getting old should be avoided even if it means longing for its only alternative. Write me down in the book of death, is Emanuel’s plea to God, when I’m no longer the young man I used to be with all of its blessings. It is a prayer that runs counter to the most basic teachings of Judaism as well as the wisdom of the Torah and its rabbinic commentators.
Three of the difficulties Ezekiel Emanuel posited as reasons for his desire not to live beyond 75 were divine responses to requests by our patriarchs.
Yes, getting old today is almost considered a sin. We are a youth-worshiping Botox generation who want above all to conceal the indicators of age and to camouflage the signs that betray the passage of years, an unrealistic denial of reality which sociologists Taves and Hansen have labeled “the Peter Pan syndrome.” And yes, we’ve achieved the ability to extend our years but not to ensure freedom from accompanying pain and infirmities. We often live beyond the gift of our full mental faculties and the health of our physical capabilities.
But if we ask whether in spite of all it’s still worth it, it might come as a shock to realize that the very things we consider our problems were considered by our rabbinic sages to be the key to significant blessings. In fact, in an incredible passage in the Midrash, three of the difficulties Ezekiel Emanuel posited as reasons for his desire not to live beyond 75 were divine responses to requests by our patriarchs, Abraham Isaac and Jacob!
Getting Old
The very first time the Bible makes reference to old age is with regard to Abraham. “And Abraham was old and well stricken in age; and God had blessed Abraham in all things.” (Genesis 24:1). Why had this never been mentioned previously in connection with anyone else? The Rabbinic answer is because this was the first time that noticeable aging had ever happened!
How remarkable to learn that Abraham pleaded with God to grant him as blessing that very sign we today consider a curse. "Master of the universe,” Abraham prayed, “if there is no such thing as old age, there would be no difference between an immature child and the mature man who has acquired a certain level of intelligence, experience and wisdom. That is not good. If you will be so kind, crown us with old age. Put a little white in the hair, make a person look a little bit older, more distinguished. Then others will know to whom to give greater respect."
The Midrash concludes that upon hearing this request, God said to Abraham: "A good thing have you asked for. And from you it shall begin." And that’s why “Abraham was old and well stricken in age; and God had blessed Abraham in all things.” What Abraham brought to the world was divine agreement with his desire that age deserves to be honored for those ways in which it is superior to youth.
Building Character
Isaac too had a wish. The Midrash infers it from the verse that tells us, "When Isaac grew old, his eyes became weak from seeing, and he became blind" (Genesis 27:1). Nowhere before in the Bible do we find any mention of physical affliction. It is a biblical first and seems to come out of nowhere. How can we account for his blindness? This too, remarkably enough, was the divine response to a prayer.
The Midrash fills in the blanks. "Master of the universe," Isaac said to God, "I am afraid to face you, never having suffered hardship on this earth. I know that the challenge of confronting difficulties as well as finding the faith to overcome them will make me a better person. I pray, therefore, let me endure some suffering now and make me more worthy." To this request, God again replied, "A good thing you have asked for. And from you, it shall begin."
For almost all of mankind, pain seems something to be avoided at all cost and disabilities to be detested. And yet there are those who came to understand that character, as Booker T. Washington put it, is the sum of all we struggle against. Helen Keller had the profound wisdom late in life to say, "I thank God for my handicaps, for, through them, I found myself, my work, and my God." There is great truth in the aphorism that "The gem cannot be polished without friction, nor man perfected without trials." And Isaac was the first one to intuitively grasp this fact and have the courage to plead for it to play a role in his life.
Surely there is much about human suffering that we cannot understand or attempt to justify. But it is an important reminder for us to learn that there are ways in which suffering may at times achieve a truly noble purpose and we would be foolish to forsake life simply in order to avoid it.
Warning: Death
Which brings us to Jacob, the third of the patriarchs. He too made a wish that on the surface seems like curse rather than blessing. He also is described with a biblical first. Before him there is no record of anyone going to his death preceded by a final illness. The almost universal legend has it that in the very earliest days the way people died was with a sneeze. Man was created by way of God blowing His spirit into Adam’s nostrils. The moment of death therefore saw the final breath of life expelled from the same place it had originally entered.
Jacob wasn't afraid of dying but what he deeply feared was this kind of sudden death. He also turned to God with an appeal. "Master of the universe,” he prayed, “people are dying without warning. Their breath is taken from them, and they are gone in an instant. They sneeze and they are dead. They do not have a chance to settle their affairs, to make peace with those they have wronged, to ask forgiveness of God and fellow man. Please, God, give me the gift of a final illness before I am cut down by the Angel of death."
For yet a third time, God replied, "A good thing you have asked for. And from you, it shall begin." So in Genesis 48:1, we first find the word for serious illness, choleh, in Hebrew. A messenger comes to Joseph to tell him, "Behold, your father is ill." And shortly thereafter Jacob dies, but not before he has the opportunity to bid a final farewell to his family.
Imagine. Jacob could have departed from this world in the same way as all of his contemporaries. Not a moment of worry, no stress, no anxiety. Not even the sad scene of family sitting close to the deathbed, tearfully coming to terms with an obviously imminent tragedy. Yet Jacob chose the way of awareness. Even though throughout his entire life he knew what we all know and recognized his mortality he felt there was a great deal to be gained from the time that undeniably precedes a final parting.
I have witnessed many people making great use of their last moments.
I have witnessed many people making great use of their last moments. We speak of preparing to meet our maker. It is an opportunity that by definition can only come once in a lifetime. According to the Talmud, sincere repentance at the very end can undo years of transgression. I've seen how the dying have become transformed as they reflect upon their past with the much clearer vision of approaching eternity.
Knowing that one is imminently going to die also permits reconciliations that otherwise would never have been possible. I have seen enemies embracing at a deathbed, children estranged from parents apologizing, husbands and wives in the midst of divorce proceedings begging each other for forgiveness. What people say before death carries incredible weight.
Jacob knew why he wanted the gift of warning even though it came with suffering. His gain far exceeded his pain. That must be of comfort to all those who are granted time to prepare for their parting. Like Jacob, they must be grateful for the special opportunity granted to them to say their final goodbyes.
And that is why I urge Ezekiel Emanuel to reconsider. Those things he fears about aging are all part of a divine plan with purpose and meaning. Every moment of the gift of life has significance and great potential for fulfilling God’s will for the universe.
I find it serendipitous that Emanuel chose the year 75 for ideal death when it was the very age at which Abraham first began his momentous mission to transmit his monotheistic belief to the rest of the world. Achievements come when God wills them, oft times quite late in life. And as an octogenarian I will pray for additional time to continue to play whatever role God has in mind for me as the reason for my presence here on earth - at least until 120.
(20) Anonymous, February 7, 2015 12:40 PM
Every Experience Is Different
As part of my work, I visit nursing homes. One woman I recently met, age 66, was robbed and beaten. She can no longer walk or hear. She can no longer change herself or toilet herself. She does not speak English. The home is constructing a bilingual message board so she can request selected things, such as a diaper change.
I can't advise others on whether life is worth continuing. I am glad for the lucky ones who have avoided some of the more brutal tragedies of life.
(19) Marilyn Mendoza, October 10, 2014 3:40 PM
Even at 100
My father passed away at age 100 three years ago. He lived on his own and looked after himself until he was almost 99, leading the Shacharit service every Shabbat. For the final year of his life he entered a Jewish nursing home where he actively participated in all areas of Yiddishkeit, even though he was the oldest resident. He was an inspiration to all who knew him and is my strength today. You never know who you will influence during your life.
(18) zen, September 23, 2014 10:08 AM
How timely! at 66, I haven't changed my target for another 54yrs., at least. Thanks.
(17) Boca Mom, September 22, 2014 5:16 PM
wonderful!
I love this article! I would only add that think of the poor grandchildren who would miss out on their grandparents if they died at such a young age. Grandparents are so wonderful for people to have, and since people are having children later and later, so many kids would miss out of a lot of love and wisdom that their grandparents would be able to give them. Maybe you could do a part two on the matriarchs influences on their grand children. I would love to read about that!
(16) Anonymous, September 22, 2014 3:11 PM
In some hospitals including those in Israel, the doctors send terminaly ill patients in "bayit ve Lev" where they get rid of them under the pretense that they are unstaffed. I know that, for a fact it happened to my husband.
(15) Inbar, September 22, 2014 8:40 AM
So true!
When my beloved grandmother died at 95, for many of us it was way too early. Had we been blessed with another 25 years of her presence among us, she would have been just as loved and cherished. Probably, even more!
Life only becomes worthless if you consider people only to have any worth as long as they can be 'productive' workers. Being active with creative work, learning new skills at high age keeps the mind flexible and healthier.
But even for those who become more and more helpless physically, it does not have to mean they cannot contribute. How many people are paying high sums to have someone listen to them? Strangers! How much more would they be willing to pay to have someone listen who really loves you?
And even if someone cannot contribute in any way we can easily recognize, why should that make them worthless? At the beginning of our lives we cannot do anything for ourselves, and are (usually) lovingly taken care of. It can be a beautiful way of ending a life, by being lovingly taken care of once more, especially if this is done by some of those who received your care. And being treated with respect.
This seems to me one of the ways our modern society is very, very unhealthy, and we really should fix this soon!
May you be blessed with many more healthy, happy years, keep increasing in wisdom and share it with us!
(14) Anonymous, September 22, 2014 7:08 AM
Good article, but...
Rabbi Blech writes beautifully of each of our avos and their "contributions" to old age. As so many other aspects of religiosity, it sounds good in theory. It really does! But those of us who have watched, or are watching, an elderly parent disintegrate before our very eyes, it only sounds good in theory. Not everyone is blessed with good physical and mental health in their old age, nor is everyone blessed with the hashkafa to "see the good" even in difficult times. For those who have lived a healthy, productive life to be reduced to wearing diapers and needing someone to feed and bathe them, it's demoralizing and humiliating. I would never recommend ending a life earlier than G-d's timing, G-d forbid, but I think this article simplifies a very complicated and difficult period in some people's lives.
Laya, September 22, 2014 8:24 PM
more than one way to see it
When my mother in law was dying, her worst fear was that she would not be able to care of her toileting needs. Her compassionate doctor said, "well, when you came into this world you couldn't and it was ok then." Honestly we don't know what our "egos" need. I'm watching my mother on her journey with Alzheimer's and though she is not "productive" or "sharp" like she was, she has a sweetness that blesses the world. My experience is that what is the most complicated is sorting out our emotional responses to what we perceive as loss. Maybe it's loss and maybe it's just the constant change that is part of the process of life.
(13) Steve B., September 22, 2014 6:59 AM
Dr. Emanuel who wants to cut short his life at 75 is the brains behind Obamacare.
How much of his personal philosophy did Zake Emanuel put into Obamacare. Scary. Electio s do have consequences.
(12) Remi Lessore, September 22, 2014 6:33 AM
ailments and reconciliation
My 80 year-old cousin discovered he had cancer of the ear.
This prompted him to be reconciled with his sister who had been estranged for years.
She accepted the reconciliation.
He had been poisoned during the Algerian war and was pronounced dead. He woke up in the morgue.
He believed it to be a miracle.
His comment to me on his cancer was: "I was dead once and it didn't do me any harm."
Then, this summer, four days before half his ear was due to be amputated, he removed the dressing and the cancer was gone.
To him it is just another miracle. He knows death will come one day and he looks forward to it while enjoying himself here and now.
Co-incidentally he is guardian of the resting place of the martyr Flavia Domitilla counted as Jewish by Jews and Christian by Christians.
(11) Malki, September 22, 2014 6:25 AM
Thank you
Thank you rabbi Blech for this important article.
(10) Fred Passman, September 22, 2014 2:28 AM
What is 75?
I am of two minds pondering Rabbi Belch's article. I fully agree that 29 (Logan's Run), 75 (really arbitrary) or 120 are just numbers. Is it a blessing for the body to continue on, once the mind has succumbed fully to Alzheimer's or other geriatric dementia? It's not in our hands to decide, but I have empathy for those who fear lingering on long after they have lost the ability to communicate coherently, or to care for their basic personal needs.
(9) Chana, September 22, 2014 12:26 AM
To 120
Moshe had all his faculties until the very end. If we could know that we would have our faculties like our great teacher we could face our final years with equanimity.
(8) Miriam w. Cohen, September 21, 2014 10:26 PM
It depends on the quality of life
I can honestly say that at age 78 I still want to live a bit longer but in good health. Yes, I have some aches and pains,twinges in the mornings, get a bit more tired and need to nap, but we walk to shul 1.3 miles, back and forth, go to lectures, museums, exercise class 3 x a week, plant flowers- great family, it's a good life.everything ends, no regrets and I will accept the end too. Why pick 75, 80, 90, and yes Obama care is not kind to Seniors,
(7) Amy Sharf, September 21, 2014 7:46 PM
Don't just pick a number
I definitely don't agree with Emmanuel that a number like 75 is the limit of a good life. But I also do not agree with Blech that life is worth living at all costs.
Our sages and forefathers did not have breathing tubes, respirators, and pain killers that enabled people to live in vegetative states. Just because modern medical science can keep you alive does not mean that it is appropriate or what Hashem intends.
People need to think about this and let their family members know exactly what their wishes are. It Is not up to the doctors or your children to make those decisions, everyone should make those decisions themselves.
(6) Wallace Schwam, September 21, 2014 4:12 PM
When 75 is not 75
Chronological age is different than physiological age. There are people who at 75 behave as though they're in middle age. Then, due to fate, genetics, and/or a life misspent, are all through at 35.
(5) Cincinnati, September 21, 2014 3:53 PM
Thank you Rabbi
Blech for yet another insightful article. Dr. Emauel is not only a commentator for a magazine and medical "researcher," but also a integral part in shaping health care in America as a consultant to the government. It is a disturbing trend when such opinions as written in his most recent article, not only get society's but government's seal of approval. The possibility of reversing this downward trend of morality seems slim.
(4) Anonymous, September 21, 2014 3:43 PM
100 years old
My husband's cousin, turned 100 this past April. I wish for all of us to be able to function at 100 years old as she does. Just last Sunday, she called us, (she lives alone in Independent Living) and wished us a good year, asked about family members ,and said that she feels fine. She was on Dr. Oz a few months ago, because it is not just her longevity that so is amazing, though not uncommon, it is her quality of life. The fact hat she still knits and crochets, the fact that she plays bridge twice a week, the fact that writes poetry and goes to her shul every week. The fact that she dials the phone herself, and has a coherent conversation, no babbling, and the fact that she laughs! She has a walker, but during the times that I saw her, rarely used it.
When we say on Yom Kippur "Al Tashlichayni l'eyt Ziknah," "please do not send me to old age", we are not talking about this kind of old age. We are talking about the kind that renders a person incapacitated, dependent on others like a baby, and completely without memories of his or her life. There is nothing worse than that.
When she leaves this world, it will be as a whole person mentally and physically. Such a gift!!
(3) Alan, September 21, 2014 3:29 PM
Benefits of Growing Old
Ezekial Emanuel's wish to die at 75 reminds me of A. E. Houseman's poem "When I was One and Twenty." I hope to live a long and vibrant life, but I don't fear infirmities of age. For a look at how one man faced illness and death, I commend Gordan Zacks' book, Redefining Moments: End of Life Stories for Better Living, published July of this year shortly after his death.
My parents and my wife's parents are all living, thank Hashem, and their ages range from 86 to 91. How poorer my wife and I would be if they had decided not to live past 75. They have now lived to see great grandchildren and, just as important, their great grandchildren have gotten to see them.
I wish to point out one other potential positive of growing old and risking infirmity and loss of faculties. It can allow others opportunities to perform good deeds in behalf of the aged person. Sometimes a tragedy results in ordinary persons rising above themselves to do unselfish acts of love.
(2) HouTexan, September 21, 2014 3:29 PM
So, a Major NIH Figure is Now Saying "75 years is enough"...
OK, we now have Obamacare.
OK, so prominent Leftists are saying in public that Obamacare is an interim solution, and that single-payer is actually best.
OK, so end-of-life care tends to be some of the most expensive care there is.
OK, so one of the best ways to save money in a single-payer system is to ration care according to a metric of the patient's "social worth".
OK, so denial of anything but palliative care to those deemed too old to be of use saves tons of public money.
OK, so now a prominent government figure is saying that 75 years of life is enough for anybody.
OK, folks, get ready for your turn!
Cincinnati, September 21, 2014 5:47 PM
OK, this must be
what the majority of our society wants. We voted for it, by a significant margin, twice.
tom, September 21, 2014 6:04 PM
Softening us up?
The fact that he is a prominent government figure makes me suspicious.
Are they going to say next that it is our patriotic duty to drop dead at 75, to save Medicare funds?
(1) Mordechai Bulua, September 21, 2014 2:40 PM
The Year of "75"
The last two initials for the coming New Year in Hebrew, Ayin and Heh, have a gematriya (numerical value) of 75! This should goad us to start anew, just like our forefather Abraham, who lived life to the fullest at that age. One can also use these same two letters (Ayin, Heh) to form the phrase "Ate Ha-geula", the time of our redemption! May Moshiach come this year and may Rabbi Blech, my rebbe, continue inspiring others for many, many more years, biz hunderd un tzvanzik (120) un noch a bissel!